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解读疼痛的全貌:对疼痛管理与感知中的种族差异、文化影响及生理机制的全面综述

Unraveling the Tapestry of Pain: A Comprehensive Review of Ethnic Variations, Cultural Influences, and Physiological Mechanisms in Pain Management and Perception.

作者信息

Shah Neelay, Qazi Rida, Chu Xiang-Ping

机构信息

Neurology, University of Missouri Kansas City School of Medicine, Kansas City, USA.

Biomedical Sciences, University of Missouri Kansas City School of Medicine, Kansas City, USA.

出版信息

Cureus. 2024 May 20;16(5):e60692. doi: 10.7759/cureus.60692. eCollection 2024 May.

DOI:10.7759/cureus.60692
PMID:38899250
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11186588/
Abstract

The medical management of pain is a nuanced challenge influenced by sociocultural, demographic, and ethical factors. This review explores the intricate interplay of these dimensions in shaping pain perception and treatment outcomes. Sociocultural elements, encompassing cultural beliefs, language, societal norms, and healing practices, significantly impact individuals' pain experiences across societies. Gender expectations further shape these experiences, influencing reporting and responses. Patient implications highlight age-related and socioeconomic disparities in pain experiences, particularly among the elderly, with challenges in managing chronic pain and socioeconomic factors affecting access to care. Healthcare provider attitudes and biases contribute to disparities in pain management across racial and ethnic groups. Ethical considerations, especially in opioid use, raise concerns about subjective judgments and potential misuse. The evolving landscape of placebo trials adds complexity, emphasizing the importance of understanding psychological and cultural factors. In conclusion, evidence-based guidelines, multidisciplinary approaches, and tailored interventions are crucial for effective pain management. By acknowledging diverse influences on pain experiences, clinicians can provide personalized care, dismantle systemic barriers, and contribute to closing knowledge gaps, impacting individual and public health, well-being, and overall quality of life.

摘要

疼痛的医学管理是一项受社会文化、人口统计学和伦理因素影响的细微挑战。本综述探讨了这些维度在塑造疼痛感知和治疗结果方面的复杂相互作用。社会文化因素,包括文化信仰、语言、社会规范和治疗方法,在不同社会中对个体的疼痛体验有重大影响。性别期望进一步塑造了这些体验,影响了疼痛的报告和反应。患者层面凸显了疼痛体验中与年龄和社会经济相关的差异,尤其是在老年人中,他们在管理慢性疼痛方面面临挑战,且社会经济因素影响了获得护理的机会。医疗保健提供者的态度和偏见导致了不同种族和族裔群体在疼痛管理方面的差异。伦理考量,尤其是在阿片类药物使用方面,引发了对主观判断和潜在滥用的担忧。安慰剂试验不断变化的格局增加了复杂性,强调了理解心理和文化因素的重要性。总之,基于证据的指南、多学科方法和量身定制的干预措施对于有效的疼痛管理至关重要。通过认识到对疼痛体验的各种影响,临床医生可以提供个性化护理,消除系统性障碍,并有助于缩小知识差距,影响个体和公众的健康、福祉以及整体生活质量。